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People are neglected, not diseases: the relationship between disability and neglected tropical diseases

HAMILL, Claire Louise
et al
May 2019

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The affect of NTDs can contribute to poverty, illness, mental health and psychosocial, cognitive, intellectual and physical impairments, all of which can, in turn, result in disability through a multifaceted process upon which many other factors impinge. It is this complex and non-linear relationship between disability and NTDs that forms the basis of this review

 

Transactions of The Royal Society of Tropical Medicine and Hygiene 2019; 00: 1–6
doi:10.1093/trstmh/trz036

 

 

Towards independent living: Collecting examples from Europe

ANGELOVA-MLADENOVA, Lilia
March 2019

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This Collection is a joint initiative of the European Network on Independent Living (ENIL) and the European Disability Forum (EDF). It features examples from different EU Member States, which to a different extent facilitate the right to live independently in the community.

The examples are divided into four areas, presented in different chapters:

  • Legislation and funding: State Funded Peer-Counselling – Estonia; Direct Payments – Ireland.
  • Community-based support: Peer-Counselling for women with disabilities – Austria; Supported living for adults with intellectual disabilities – Croatia; Supported Decision-Making – The Czech Republic; Mobile Mental Health Units – Greece; Personal Assistance for People with Complex Disabilities – Sweden .
  • Involvement of disabled people: Co-Production in Social Care – United Kingdom; Participation of Organisations of People with Disabilities – Italy
  • Self-advocacy: Self-Advocacy of Disabled People – Romania

 

Expectations management; employer perspectives on opportunities for improved employment of persons with mental disabilities in Kenya

EBUENYI, Ikenna, D
et al
January 2019

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In Kenya, the employment rate for persons with disabilities is about 1% compared to 73.8% for the general population, and the situation is even worse for persons with mental disabilities. Persons with mental disabilities are often regarded as “mad”, and stand little or no chance of employment. An exploratory study was undertaken with employers and potential employers to understand factors that hinder or facilitate their employment and to gain insight into employers’ perceptions of mental disability.

A mixed method study design was adopted, including in-depth interviews (n = 10) and questionnaires (n = 158) with (potential) employers in Kenya to explore the barriers and facilitators of employment for persons with mental disabilities

 

Disability and Rehabilitation, https://doi.org/10.1080/09638288.2018.1534006

 

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

Psychosocial disability in the Middle East

BOLTON. Laura
May 2018

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A K4 helpdesk report, commissioned by DFID (UK), provides a rapid review of literature to provide best estimates of psychosocial disability in specific countries in the Middle East.

Topics discussed include:

Prevalence and different forms of mental health conditions and psychosocial disability

Factors influencing prevalence

Differences across demographics

Provision for those with psychosocial disabilities

Community mental health: Theory, practices and perspectives

WYNGAERDEN, Francois
May 2018

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Mental health problems are commonplace and affect more than one in four people worldwide. They are responsible for a quarter of all disabilities. This document aims to provide a basis for exploring these concepts as part of more in-depth work, including an update of the 2011 mental health framework document.

 

A seminar was held in Kigali, Rwanda on 7 - 9 December 2017. It brought together 45 participants from 12 countries to think about and discuss community mental health concepts and practices. The objectives of this document are twofold:

• Set out analysis by an external expert, with a focus on community mental health at HI, in light of the literature and concepts and practices within the sector

• Undertake preliminary work to identify new concepts for implementation, based on the aspects covered in the seminar, as part of ongoing in-depth work in this area, including the updating of the 2011 mental health framework document.

 

Case histories from Rwanda, Lebanon and Madascagar are given. There is an extensive bibliography in the Annex

 

This document is intended for HI and partner staff members who work in the mental health and psychosocial support sector. It is also intended for HI staff working on mental health strategy. It can also be used to feed into the work of field staff developing, implementing and assessing mental health and psychsocial support programmes

Where there is no psychiatrist A mental health care manual

PATEL, Vikram
HANLON, Charlotte
March 2018

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This is a practical manual about mental health care, aimed at community health workers, primary care nurses, social workers and primary care doctors, particularly in low resource settings. It describes more than 30 clinical problems associated with mental illness, using a problem-solving approach to guide the reader through their assessment and management. It addresses the lack of understanding of mental health among many health workers. Mental health issues as they arise in specific contexts are described - in refugee camps, in school health programmes, as well as in mental health promotion. The final section helps the reader to personalise for a particular location, for example, by entering local information on voluntary agencies, the names and costs of medicines and words in the local language for symptoms.

 

This product is an update of the first edition 2003. It is also available as Open Access.

Labour market inclusion of people with disabilities: Paper presented at the 1st Meeting of the G20 Employment Working Group

INTERNATIONAL LABOUR ORGANISATION (ILO)
ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT (OECD)
February 2018

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A common understanding of how to approach the employment of persons with disabilities in a way that respects social justice, human rights and decent work as a key element of more inclusive economies and societies is sought. Having the employment of persons with disabilities on the G20 agenda is also a reflection of the increased attention to the rights of persons with disabilities both at a national as well as at an international level. The contribution focuses on one particular group of people with disabilities, namely those who may have been born with disabilities or may have developed some during their lives, but either way have remaining work capacities and are at working age. 

Employment-to-population ratio statistics for persons with and without disabilities are provided for some of the G20 countries. Economic and social determinants of low employment rates of people with disabilities are discussed.

 

Policies across G20 countries for the labour market inclusion of persons with disabilities are discussed

  • demand side - promoting disability inclusion within the private and public sector
  • supply side - ensuring that persons with disabilities have the skills as demanded by the labour market
  • making the environment more enabling 
  • mental health as a special challenge
  • measurement and quality data to inform evidence-based policies

 

Report of the informal consultation on stopping discrimination and promotion inclusion of persons affected by Leprosy. New Delhi, 14–16 Nov 2017

COOREMAN, Erwin
WHO SEARO/Department of Control of Neglected Tropical Diseases
et al
2018

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An Informal Consultation on Stopping Discrimination and Promoting Inclusion of Persons Affected by Leprosy was held in New Delhi from 14 to 16 November 2017. Forty delegates with diverse backgrounds, experience and expertise enriched the discussions. Persons affected by leprosy brought to the table the challenges faced in daily life and suggested actions to be taken to reduce stigma and discrimination related to leprosy. Representatives of national programmes presented actions taken in their respective countries. The participants acknowledged the fact that stigma and discrimination related to leprosy still exists at a significant level. Information about stigma and discrimination related to leprosy needs to be collected in a more systematic manner to assess the magnitude of the problem and to further plan activities to reduce it.

Key recommendations from the consultation included counselling and reporting of incidences of discrimination. Efforts should be continued to inform facts about leprosy to the community.

The participants strongly recommended that leprosy programmes should adopt a ‘rights-based approach’ in line with the Sustainable Development Goals.

The Journal of Mental Health Training, Education and Practice, vol.12, no.4 Special Issue - Mental health pathways for people with intellectual disabilities: the education, training and practice implications

CHARNOCK, David
WRIGHT, Nicola
Eds
November 2017

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"This special edition aims to address some of the complexities and challenges faced in mainstream mental health services in three ways. First, to highlight the specific needs of people with intellectual disabilities and mental health problems. Second, to promote the importance of interdisciplinary working and learning in relation to mental wellbeing and intellectual disability, showcasing innovative approaches to care and finally, to offer a voice to specialists from intellectual disability practice and research to foster practical and conceptual thinking in relation to this group of service users"

There is a freely accessible editorial and there are six papers:

  • People with intellectual disabilities accessing mainstream mental health services: some facts, features and professional considerations
  • Psychiatry and intellectual disabilities: navigating complexity and context
  • Development and dissemination of a core competency framework
  • Mental health staff views on improving burnout and mental toughness
  • Using wordless books to support clinical consultations
  • Actors with intellectual disabilities in mental health simulation training

Full articles are not free.

Mental health assessments in refugees and asylum seekers: evaluation of a tablet-assisted screening software

MORINA, Naser
et al
October 2017

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Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface.

Conflict and Health 2017 11:18

https://doi.org/10.1186/s13031-017-0120-2

Postpartum Depression: Signs and Resources for Help

Nursing@Georgetown
July 2017

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This resource provides insights into the symptoms of postpartum depression and how to support a loved one with PPD. Also included in the article are insights on how to find providers and community groups that offer free resources. Readers can also learn what to do in crisis situations to ensure that important preventative measures are taken when needed.

Social relationships, mental health and wellbeing in physical disability: a systematic review

TOUGH, Hannah
SIEGRIST, Johannes
FEKETE, Christine
May 2017

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The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities. The objective is to summarise a complex and heterogeneous body of empirical research on the association of different social relationship constructs with mental health and wellbeing in physical disability and to highlight conceptual and methodological deficiencies in the field of research. The literature search included original articles published in English between January 1, 1995 and May 31, 2016. Data was extracted on study and participants’ characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesise findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality.  Of the 63 included studies, 47 were cross-sectional and 16 longitudinal.

BMC Public Health (2017) 17:414 

DOI 10.1186/s12889-017-4308-6

HIV & AIDS and rehabilitation. Factsheet.

HANDICAP INTERNATIONAL
March 2017

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The Human Immunodeficiency Virus (HIV) is a virus that makes the immune system collapse, making a person totally defenceless to infections. A person living with HIV may experience episodic and/or chronic impairments. These may result from illness and/or from treatment side effects, in particular: general fatigue and weight loss; neurological disorders; mental and cognitive disorders such as dementia; and joint and muscle problems. Different examples of rehabilitation across the care cycle are given. A case study in India is provided.
 

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Towards an inclusive judicial system. Penal process and psychosocial disability

Documenta. Analyses and action towards social justice
January 2017

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This report gives a first general insight on barriers people with disabilities are facing when they have to deal with the criminal justice system as accused of having committed a criminal act in the Federal District. Its purpose is to provide a reflection on how the justice system could cope with their special needs in a more appropriate way, to ensure that human rights and access to justice of people with disabilities occur on equal basis with others.

The probability that people with psychosocial disabilities are faced with the criminal justice system is higher than for the rest of the population. This can be explained to a large extent by the existing incomprehension concerning disability, which is even more of an issue when it comes to psychosocial disability as it seems to be one of the less well understood and one of the more stigmatized as well.

In addition to the preconceptions and the lack of capacity building, we may add the existence of a discriminatory penal legislation which keeps on looking at people with disabilities as if they weren’t subject with rights and obligations, but insists on an anachronistic vision that looks at them as objects requiring treatment and cure.

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

CREPET, Anna
RITA, Francesco
REID, Anthony
et al
January 2017

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Abstract

 

Background

 

In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15.

 

Methods

 

All asylum seekers transiting the 15 MSF-supported centres were invited to a psycho-educational session. A team of psychologists and cultural mediators then provided assessment and care for those identified with MH conditions. Potentially traumatic events experienced before and during the journey, as well as post-migratory living difficulties, were recorded. All those diagnosed with MH conditions from October 2014 to December 2015 were included in the study.

 

Results

 

Among 385 individuals who presented themselves for a MH screening during the study period, 193 (50%) were identified and diagnosed with MH conditions. Most were young, West African males who had left their home-countries more than a year prior to arrival. The most common MH conditions were post traumatic stress disorder (31%) and depression (20%). Potentially traumatic events were experienced frequently in the home country (60%) and during migration (89%). Being in a combat situation or at risk of death, having witnessed violence or death and having been in detention were the main traumas. Lack of activities, worries about home, loneliness and fear of being sent home were the main difficulties at the AS centres.

 

Conclusion

 

MH conditions, potentially traumatic events and post-migratory living difficulties are commonly experienced by recently-arrived ASs, this study suggests that mental health and psychosocial support and improved living circumstances should be integrated into European medical and social services provided by authorities in order to fulfil their humanitarian responsibility and reduce the burden of assimilation on receiving countries.

 

Keywords

 

Immigration Asylum seekers Refugee Mental health Italy Europe Traumatic event Operational research

The economic burden of dementia in China, 1990–2030: implications for health policy

WORLD HEALTH ORGANIZATION
January 2017

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Objective To quantify and predict the economic burden of dementia in China for the periods 1990–2010 and 2020–2030, respectively, and discuss the potential implications for national public health policy. Methods Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs – e.g. the costs of transportation – and indirect costs due to loss of productivity. We excluded comorbidity-related costs.

Findings The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030.

Conclusion In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.

Greece: Refugees with Disabilities Overlooked, Underserved

HUMAN RIGHTS WATCH
January 2017

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Refugees, asylum seekers, and other migrants with disabilities are not properly identified and do not enjoy equal access to services in reception centres in Greece.  On the basis of research carried out in mainland Greece and on the Greek islands in October 2016 and January 2017, and follow-up phone interviews in December 2016 and January 2017, Human Rights Watch found that asylum seekers and refugees with disabilities are not properly identified in Greece, in part because of a rushed registration process and the need for better guidance for staff. Without an adequate understanding of the scale and needs, aid agencies cannot respond effectively. Problems with equal access to water and sanitation services, food distribution, shelter, and health care including mental health and psychosocial support are reported.

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